Individual provider Active NPI

Chalmers Rieger Wood IV, D.D.S.

  • Dentist
  • Tulsa, OK
National Provider Identifier
1104186113
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6416 Issued in OK
Practice address
3520 E 31St St
Tulsa, OK 74135-1505
Phone
(918) 742-2488
NPI assigned
May 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6416 OK Primary
Dentist 122300000X 2012016058 MO

Addresses

Primary practice location

3520 E 31St St
Tulsa, OK 74135-1505

Mailing address

3520 E 31St St
Tulsa, OK 74135-1505
Phone (918) 742-2488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160118000112 MO Order and Referring Only - DentistPractitioner - Dentist 5193973907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6416OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Physicians Past Accepting new patients
C. Rieger Wood, III, D.D.S., Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1104186113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741351505",
            "telephone_number": "918-742-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741351505",
            "telephone_number": "918-742-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CHALMERS",
        "middle_name": "RIEGER",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6416",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2012016058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.